Organization
FASTRACK MEDICAL SUPPLIES,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY BALBON RARA (PRESIDENT)
(847) 982-9440
Entity
Organization
Contact information
Practice address
7301 N LINCOLN AVE, SUITE 215, LINCOLNWOOD, IL 60712-1735
(847) 982-9440
(847) 982-9442
Mailing address
7301 N LINCOLN AVE, SUITE 215, LINCOLNWOOD, IL 60712-1709
(847) 982-9440
(847) 982-9442
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Enumeration date
08/22/2007
Last updated
03/06/2009
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